If you want to understand the state of breastfeeding promotion in the US today, there’s no better place to start than the vast gulf between lactivists’ (“Breast Is Best”) fears and nurturists’ (“Fed Is Best”) fears.

There is something very, very wrong about valuing a process more than an outcome. Sure lactivists insist that breastfeeding promotes optimal outcomes, but the outcomes themselves show that this isn’t true.

Lactivists fear being shamed for public breastfeeding; Fed Is Best advocates fear their babies’ deaths!

Lactivists fear that information about risks will discourage breastfeeding; nurturists fear that suppressing information about risks will discourage safety.

We’ve all heard about baby Landon Johnson who had a cardiopulmonary arrest due to dehydration less than 12 hours after being sent home from the hospital where his mother was repeatedly assured by lactation consultants that he was getting enough breastmilk.

Now comes word of another perverse and heartbreaking tragedy. A mother is suing an Oregon hospital because her newborn suffocated to death in her hospital bed.

A new mother who accidentally smothered her 4-day-old baby in a hospital bed has filed an $8.6 million lawsuit against Portland Adventist Medical Center.

Monica Thompson faults the Southeast Portland hospital for putting her newborn, Jacob, in bed with her in middle of the night so she could breastfeed him while she was unsupervised and heavily medicated with painkillers and sleep aids.

Thompson dozed off, then awoke to find that Jacob wasn’t breathing on Aug. 6, 2012, according to the lawsuit filed last week in Multnomah County Circuit Court.

Jacob suffered catastrophic brain damage, and his parents removed him from life support six days later after doctors told them that his comatose state was irreversible.

It’s an unspeakable tragedy because a new mother lost her healthy firstborn child to a cause that was easily preventable; it’s perverse because Jacob died as the result of the hospital’s efforts to meet the requirements of the Baby Friendly Hospital Iniatiative (BFHI), a program to promote breastfeeding because of its purported health benefits.

It really ought to be called the Baby Deadly Hospital Iniative because its major tenets are incompatible with safe infant care. These include censoring healthcare providers so they cannot provide accurate information about the risks of breastfeeding; banning formula supplementation; and closing well baby nurseries. The BFHI also bans pacifiers despite copious evidence that they reduce the risk of sudden infant death syndrome (SIDS).

Breastfeeding promotion has been causing so many injuries and deaths that the American Academy of Pediatrics has published several papers on these tragedies. The latest evidence includes:

Together these papers show that the BFHI doesn’t increase breastfeeding rates, ignores the scientific evidence on pacifiers, formula supplementation, and Sudden Infant Death Syndrome (SIDS) and leads to preventable infant injuries deaths when babies fall from or get smothered in their mothers’ hospital beds.

The bottom line is that the fears of lactivists are incommensurate with the fears of Fed Is Best advocates.

Lactivists are primarily concerned with their feelings — being able to breastfeed in public without censure, getting support for breastfeeding difficulties, improving their self esteem by feeling they are doing something important for their babies. Don’t get me wrong; those are fine goals and I strongly advocate for lactation services for those who wish to breastfeed and the right for women to breastfeed whenever and wherever their babies get hungry, BUT these fears pale into insignificance next to women’s fears that their babies will die due to insufficient breastmilk, smothering and falling from hospital beds.

It’s long past time to abolish the Baby Friendly Hospital Initiative. There is precious little evidence that breastfeeding saves the lives of term babies and a growing body of evidence that we are breastfeeding babies to death instead.

What is wrong with the writer here? Why do you leave out the biggest problem at the hospital in Oregon? The DOCTORS! Blaming the IBCLCs alone is just insane. For one thing, any baby who became that dehydrated so quickly had something going on that was a lot more that breastfeeding. Hospitals work in teams, so not looking at the docs and RNs is just plain denial. For some reason you hate breastfeeding and seem to think that all IBCLCs are incompetent. You would be wrong! I use formula in my practice when a baby needs to be fed and can’t get enough human milk. It is a tool, period. I have seen your work before and your lack of breastfeeding knowledge, evidence, and obvious bias and hate on for breastfeeding are both frightening and irresponsible. Scaring the crap out of people isn’t good medicine.

The Bofa on the Sofa

For one thing, any baby who became that dehydrated so quickly had something going on that was a lot more that breastfeeding.

How quickly do you think it’s coming on?

How long can a baby go without any liquids before it becomes dehydrated? I know that adults can’t go all that long (a couple days at most) without water, and that is for death. Complications due to thirst set in earlier than that.

I (and Dr Amy) don’t disagree that doctors and nurses are a huge problem, in that they too much sucker into the the “breastfeeding or nothing” crowd, so you seem to be arguing a straw man.

Amy Tuteur, MD

Are women who claim to have had miscarriages lying? Are they misunderstanding what happened? Did doctors cause the miscarriages? Does anyone who believes women who claim to have had miscarriages hate pregnancy?

Are women who claim to be infertile lying? Are they misunderstanding what happened? Did doctors cause the infertility? Does anyone who believes women who claim to be infertile hate pregnancy?

See how idiotic and unfeeling people sound when they refuse to believe women and pretend that pregnancy is perfect? That’s just how you and other lactivists sound: idiotic and unfeeling.

Shawna Mathieu

I bought into the whole “breast is best” thing. I was so brainwashed I broke down when the doctors told me my son, who couldn’t latch on to my flat nipples and was dealing with hypoglycemia from my GD, HAD to have supplementation. I fought them, can you believe it?
Reading the thing about the woman who overlaid on her baby, I feel 100% better about having had my daughter go to the nursery at night so I could take Ambien and get a decent night’s sleep.

Heidi_storage

You were lied to at an extremely vulnerable time. That sucks, and it needs to stop.

Ozlsn

It’s stories like these that make me think “thank God my son was in NICU”. That first night I couldn’t finish a sentence without falling asleep in the middle of it. There is no way I could have cared for a newborn.

Emilie Bishop

Did anyone see the People article that said this couple went through 12 YEARS of infertility before this happened? I can’t imagine. I would have killed myself. I only had four years of infertility and when my son got readmitted for starving and dehydration, I thought he would die and I just went numb. Like we’d gone through all we did just to have our hearts shatter again. He survived, thankfully, but this one didn’t. That poor, poor couple. How utterly heartbreaking.

Merrie

As if this whole story wasn’t already horrifying and heartbreaking enough.

Bbyardley

This is absolutely insane. I used to work med-surg as an RN. A 75-year-old man would be labeled as ” a falls risk” based on a screening questionnaire and would have increased nursing checks bed alarms a sign on the door be close to the nursing station etc. that’s because we know hospitalized patients are at high-risk for falls which can be dangerous or even fatal . But nurses just willingly put a tiny newborn in an extremely dangerous situation ? Awful. In this vein, is anyone else bothered by the normalization of side laying nursing and cosleeping? Make is an easy sleeper so far so I try not to judge those who cosleep for sanity. But reading an article about “post partum hacks” that says side- lie nurse your newborn so you can sleep and rest during breast-feeding” is crazy! Again , maybe some people can do this while remaining totally alert , but I think it’s hard enough to be alert breast-feeding in the middle the night while sitting in a chair. Side lying nursing seems like a really easy way to fall asleep and smother your baby who is happily passed out on the boob….
I Love breast-feeding and Am in the ” fun easy and convenient camp ” with no major challenges but I have never deviated from safe sleeping guidelines ( while unsupervised-she definitely naps in strolller, etc) and it has not hurt I Nursing relationship in anyway.

tired

When will insurance companies wake up to the fact that they’re paying $$$ for two patients to be taken care of, but one of those patients is being forced to provide most of the care for the other?

Insurance companies aren’t known for their generosity. Why are they not using this as an excuse to bargain down negotiated payments to these dirtbag hospitals?

TsuDhoNimh

“medicated with Ambien and Vicodin a few hours” before the nurse waked and LEFT the baby with her.

You aren’t supposed to drive, use sharp things or power equipment while under the influence of those drugs, but handling a newborn is OK?

swbarnes2

Yeah, I’m sure in every part of the hospital, patients on strong medication after a daylong medical ordeal are held responsible for the health and safety of other highly fragile patients.

tired

Because a (good) mother will magically wake up if her baby is in danger. /s

I’m hoping there aren’t any mothers on the jury, because they’ll be so busy telling themselves and each other why this would NEVER have happened to them that they won’t get around to holding the hospital responsible for its despicable negligence.

Empress of the Iguana People

Maybe, maybe not. If I were on the jury, I wouldn’t be so sure of my abilities

attitude devant

Not true for me. Having children so thoroughly radicalized me (and alerted me to that fact that our culture fails mothers and children every day in myriad ways) that 27 years later I still breathe fire about it.

BeatriceC

Unfortunately, I’ve already seen victim blaming of the mother in groups where I was surprised to see it. “She should have known it wasn’t safe and put her baby back in the bassinet”, “She shouldn’t have let the nurse hand her the baby.” “She should have insisted the nurse take the baby if she was that tired.” “Why wasn’t her husband in the room with her?” “If she needed that much help maybe she shouldn’t have had a baby to begin with.”

These are just the tip of the iceberg, and they were in a group that’s not necessarily known for this kind of bullshit.

Heidi

I’ve witnessed my mother on Ambien and it is one reason I have yet to let her keep my son overnight! She takes it every night, and although she is in a fair bit of denial about how she behaves on it, I have witnessed her stumble around in a stupor shoving thousands of calories of foods she doesn’t even like in her face. Why would anyone, or at least medical staff who should know better, expect someone on Ambien to be able to take care of a baby?! I wouldn’t trust anyone’s judgement or ability to say, “Take the baby back, I’m too tired” on it.

I know you aren’t one of those people who is saying any of that, but WHAT?! She was drugged! She didn’t have the capacity to make those decisions! That’s why she shouldn’t have been left alone with a newborn in the first place! AAARRRGH!

BeatriceC

I don’t want to name the group because it’s an otherwise mostly good group and I don’t want to create drama. I haven’t looked today, but I’d be surprised if the admins didn’t shut that shit down fast. Unfortunately admins can’t read everything the second it gets posted, and can’t control what other people post, so sometimes people say things they shouldn’t and get away with it until an admin sees it.

Oh, I wouldn’t suggest doing so at all. You were just the convenient venting-at person.

Gæst

Not me. They should put me on that jury – I have nothing but sympathy for mothers who unintentionally do stupid things, and that includes forgetting a child in a car for hours. I hate that it happens, it’s horrible, and I’ve luckily never done it, but…I get it.

The Bofa on the Sofa

This came up the other day. Throughout history, the approach for a new baby has been for there to be extensive help for the new mother, to the point where helpers took care of most of the baby care while the mother recovered.

Now, in these hospitals, the approach has been to go away from that completely, with new mothers left to completely fend for themselves. It’s just wrong.

itry2brational

BS. My wife is an OB/GYN, there is no conspiracy to “go away from” helping new mothers. I stayed in the hospital with her after the birth of our two children, they go out of their way to help mothers.

Daleth

Bofa is probably talking about the very inaccurately named “Baby Friendly Hospital Initiative,” which requires hospitals to phase out well-baby nurseries for newborns. IOW it requires women who may have just been awake in agony for two days straight, or who are on narcotics and recovering from c-sections, to care for their newborns alone, with no rest.

Amazed

Look for the money. Well babies nursery cost dollars. Sweet bucks. I hope she sues the pants off them. At this point, I think the only way they will take notice is if they lose’em sweet bucks.

attitude devant

I am SO GLAD she sued. The hospitals used the BFHI as a cover to cut staffing, eliminating newborn nurseries, with a callous disregard to the health and well-being of newborns and new mothers. I hope the jury piles some punitive damages on top. Hospitals pay attention to tort awards.

swbarnes2

This hospital was not on the BFHI list I checked…though that doesn’t mean it’s policies weren’t influenced by lactivism.

attitude devant

BFHI certification is a multi-year process. Most hospitals in Oregon were enrolled in that process in 2012. One of the very first steps is 24-hour rooming in, and hospitals used that policy as an excuse to end newborn nurseries, so there was nowhere but mom’s room for the newborn to be. Whether they ultimately completed the certification is immaterial.

AnnaPDE

And you know how they’ll make sure that such a situation doesn’t come up again? They just won’t give proper pain relief to breastfeeding C-section mums, with the reasoning that it’ll make them drowsy – they’ll probably make up something about how it transfers in milk, too. (I got all the good stuff, but my cousin basically nade it through on paracetamol only.) Way cheaper than hiring more staff to care for the babies.

swbarnes2

It’s insane. The AAP has these nice guidelines about safe sleeping environments for babies, a hospital bed doesn’t meet them, especially with an exhausted medicated mother in the bed too, but lactivists just don’t care what the AAP says about safety.

Empress of the Iguana People

This could so easily have been my first and I. Dem says the nurses brought the baby to me to feed but I don’t even remember his first night, thanks to the magnesium . Poor little Jacob and his poor parents.

maidmarian555

It could have been me too. The most ridiculous part of it was that I couldn’t even breastfeed as my son had a tongue tie and couldn’t latch, meaning he’d been getting formula anyway. They sent my OH home and left me to ‘look after’ my son whilst out of my face with meds and with chronic exhaustion. It was the most terrifying night of my life.

The FB page is full of women who’ve had these near misses, it makes me so sad to see the inevitable consequence of this insane policy. Poor baby. Poor family. I feel awful for them.

KQ Not Signed In

It could also have been me and my boy. I was hallucinating from lack of sleep and loopy from pain meds and exhaustion, so I was in and out of coherence and prone to drifting off (but never into a proper deep sleep so it never helped). And they’d just prop the baby between me and the bed rail with a pillow and leave.

They also had no well baby nursery and refused to take him, even when I was crying and delirious and tripping balls from lack of sleep. The only nurse who was even willing to take him was also the only one I wouldn’t trust to – she’s the one who finally gave me a bed bath (which I’d also been crying and begging for, since I was sweaty and bloody and disgusting and miserable) and didn’t cover me at all, leaving both privacy curtain and door wide open. I pleaded for her to close them or cover me (I used to help test for CNA certification, I know the damn protocol for a bed bath). She refused – it was late at night and “there’s no one around”

I don’t talk about my hospital experience much because it really did suck and I don’t want any of the NCB crowd co-opting it as ammunition against hospital birth. Shitty experience or not (and most of the bad stuff was directly resultant of NCB ideology and policies!) it was still the safest option, and while I loathe the BFHI BS, I still wanted to birth in a place that had a resus room attached to every birthing suite, a dedicated anesthesiologist, multiple operating theaters and a good NICU.

maidmarian555

I’m so sorry. I really sympathise, that sounds dreadful. I agree, most of the crappiness of my own experience stemmed from NCB ideology having been adopted by the hospital/midwives. It seems to me to be an unholy alliance of that and persistent staff/cost cutting within healthcare that appear to be driving these terrible practises. I’m still having #2 in hospital though. I don’t care how crap it is for me, I want to be where the doctors and medicine are.

AnnaPDE

Yes, this. I was totally out of it and not sure what was real or drem. And I almost turned my son’s head the wrong way (as in, 180deg and more to one side) when I thought he was lying a bit crooked.

Merrie

I didn’t have anything stronger than ibuprofen in any of my deliveries and I still dozed off reclining in my hospital bed holding my second-born when he was a day old. I woke up with him under my arm and had this thought of “I’ve gone to all this work to have this baby and now I’ve suffocated him”. He was fine but yikes! (Does every parent have numerous “there but for the grace of God” stories? This same kid ran out from between two parked cars into the street just this afternoon and almost got hit by a van.)

Empress of the Iguana People

Probably. It’s why I don’t look down my nose at parents who loose track of a child and something tragic happens. It’s just so very difficult protect them every literal second of the day, especially with the escape artists. I think girlbard might be one, too. I just bought her a tether to celebrate her first steps today.

Amy Tuteur, MD

Dr. Amy Tuteur is an obstetrician gynecologist. She received her undergraduate degree from Harvard College in 1979 and her medical degree from Boston University School of Medicine in 1984. Dr. Tuteur is a former clinical instructor at Harvard Medical School. She left the practice of medicine to raise her four children. Her book, Push Back: Guilt in the Age of Natural Parenting (HarperCollins) was published in 2016. She can be reached at DrAmy5 at aol dot com...
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